新医学2024，Vol.55Issue(10)：794-800,7.DOI:10.3969/j.issn.0253-9802.2024.10.006
过敏性哮喘个案管理的临床应用实践
Clinical application practice of case management for allergic bronchial asthma
摘要
Abstract
Objective To evaluate clinical efficacy of chronic disease management based on a case management model in patients with allergic bronchial asthma.Methods Patients with allergic bronchial asthma admitted to the outpatient of Department of Pulmonary and Critical Care Medicine of Beijing Tsinghua Changgung Hospital from February 2020 to February 2023 were retrospectively included.The effect of case management on asthma symptom control and lung function was analyzed by tracking the asthma symptom control(ACT)score and lung function at 1,3,6 and 12 months after case management.Results A total of 175 patients with allergic asthma were included,comprising 70 male(40%)and 105 female(60%),with a mean age of(45.58±13.78)years.Among these patients,139(79.4%)cases were complicated with allergic rhinitis.Pulmonary function parameters,including FEV1%pred,FEV1,FEV1/FVC,MMEF75/25%pred and PEF,were improved significantly from(87.09±18.56)%,(2.65±0.88)L,(75.09±11.93)%,52.20%(34.70%,69.30%),and(6.65±1.94)L/s to(97.80±13.81)%,(2.96±0.76)L,(84.72±11.18)%,69.20%(53.70%,86.90%),and(7.57±1.89)L/s(all P<0.001),respectively.ACT score showed a 100%good control rate after 1-year case management,with a complete control rate of 69.7%.Repeated measures analysis of variance revealed no significant differences in symptom control based on gender or allergic rhinitis history(F=0.575,P=0.681;F=2.317,P=0.059).There was interaction between age group and case management time.At 6-month case management,the ACT score of patients aged≥60 years old was significantly lower than those of patients≤44 years old and 45-59 years old(both P<0.05).The proportion of inhaled drug usage rate and accuracy rate of using inhalation medication devices at 1-,3-,6-and 12-month case management was 98.8%,86.8%,68.0%,51.4%and 98.8%,100%,100%,100%,respectively.Conclusion The case management model can significantly improve both the usage rate and correct usage rate of inhaled medication device,enhance symptom control rate,and promote lung function recovery.关键词
过敏性哮喘/个案管理/哮喘控制/肺功能改善Key words
Allergic bronchial asthma/Case management/Asthma control/Lung function improvement引用本文复制引用
李娜,李理,曾璞,张明强,郭文佳,吕茵茵,李彩宏,牟向东..过敏性哮喘个案管理的临床应用实践[J].新医学,2024,55(10):794-800,7.基金项目
国家自然科学基金(81900021) （81900021）
北京市临床重点专科项目(XKB2022B1002) （XKB2022B1002）
北京清华长庚医院研究基金(22021C1002) （22021C1002）
北京市医院管理中心"扬帆"计划临床技术创新项目(ZLRK202323) （ZLRK202323）
